Addressing Negative Stereotypes About Medicaid Enrollees

As of December 2017, more than 68 million individuals were enrolled in Medicaid, the public health insurance program for low-income people. What image do you conjure up when you think of people who receive health insurance through Medicaid?

The current discussion in Washington, DC, and in governors’ offices around the country reflects negative stereotypes about low-income people, such as beliefs that that they are lazy, taking advantage of the system, spending taxpayer money on new iPhones and other frivolities, and non-white, and it is their fault that they are poor. These beliefs are thought by many to underlie a new emphasis on imposing a work requirement on people enrolled in Medicaid. As Janel George of the National Women’s Law Center wrote, “…the caricature of an ‘able-bodied’ single mother of color ‘collecting’ public benefits and willfully refusing to work while living a lavish lifestyle—has long been resurrected in false narratives to support ‘reforms’ that would slash federal contributions to many benefit programs like Medicaid.”

Providing facts to undercut this stereotype, Vanita Gupta and Fatima Goss Graves point out that “it’s important that we expose the argument for work requirements for what it actually is — an attempt to perpetuate myths that stereotype people of color and stigmatize popular public programs that opponents simply don’t like. These racial stereotypes are not only ugly and hateful, they also obscure the actual lived experiences of people who are covered by Medicaid. For instance, most Medicaid enrollees who can work, do. According to the Kaiser Family Foundation, nearly 8 in 10 non-elderly adults on Medicaid in 2015 lived in working families, with a majority in the workforce themselves. They generally work in low-wage or minimum-wage jobs that offer either unaffordable health insurance or none at all. And many adults covered by Medicaid who are not working have commitments like caring for relatives, are pursuing an education, or have an illness or disability that prevents them from working.”

Why is this issue on Care for Your Mind? In addition to our society’s need to address health disparities in general, we should recognize that what happens with Medicaid affects many people with mental health conditions. In 2015, Medicaid covered 21% of adults with a mental health disorder and 26% of adults diagnosed with a serious mental illness (SMI, e.g., depression, bipolar disorder, schizophrenia), versus just 14% of the general adult population. When negative stereotypes drive decisions that are detrimental to our population of concern, we will challenge those misconceptions. After all, those of us in the mental health arena – whether living with a mental health condition or a family member, a provider, an advocate, or otherwise – are familiar with negative stereotypes.

Programs like “The Faces of MassHealth” (discussed in post above) are an important way to educate the public and lawmakers about the lives that policies are affecting. There may be a similar project in your state, so get involved.

Your Turn

What should we do to address negative stereotypes, such as with Medicaid enrollees or people with mental health conditions?